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  1. Article ; Online: Automatic generation of conclusions from neuroradiology MRI reports through natural language processing.

    López-Úbeda, Pilar / Martín-Noguerol, Teodoro / Escartín, Jorge / Luna, Antonio

    Neuroradiology

    2024  Volume 66, Issue 4, Page(s) 477–485

    Abstract: Purpose: The conclusion section of a radiology report is crucial for summarizing the primary radiological findings in natural language and essential for communicating results to clinicians. However, creating these summaries is time-consuming, repetitive, ...

    Abstract Purpose: The conclusion section of a radiology report is crucial for summarizing the primary radiological findings in natural language and essential for communicating results to clinicians. However, creating these summaries is time-consuming, repetitive, and prone to variability and errors among different radiologists. To address these issues, we evaluated a fine-tuned Text-To-Text Transfer Transformer (T5) model for abstractive summarization to automatically generate conclusions for neuroradiology MRI reports in a low-resource language.
    Methods: We retrospectively applied our method to a dataset of 232,425 neuroradiology MRI reports in Spanish. We compared various pre-trained T5 models, including multilingual T5 and those newly adapted for Spanish. For precise evaluation, we employed BLEU, METEOR, ROUGE-L, CIDEr, and cosine similarity metrics alongside expert radiologist assessments.
    Results: The findings are promising, with the models specifically fine-tuned for neuroradiology MRI achieving scores of 0.46, 0.28, 0.52, 2.45, and 0.87 in the BLEU-1, METEOR, ROUGE-L, CIDEr, and cosine similarity metrics, respectively. In the radiological experts' evaluation, they found that in 75% of the cases evaluated, the conclusions generated by the system were as good as or even better than the manually generated conclusions.
    Conclusion: The methods demonstrate the potential and effectiveness of customizing state-of-the-art pre-trained models for neuroradiology, yielding automatic MRI report conclusions that nearly match expert quality. Furthermore, these results underscore the importance of designing and pre-training a dedicated language model for radiology report summarization.
    MeSH term(s) Humans ; Natural Language Processing ; Retrospective Studies ; Language ; Magnetic Resonance Imaging ; Radiology
    Language English
    Publishing date 2024-02-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 123305-1
    ISSN 1432-1920 ; 0028-3940
    ISSN (online) 1432-1920
    ISSN 0028-3940
    DOI 10.1007/s00234-024-03312-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Technical success, procedural safety, and efficacy of the Silk Vista Baby in the treatment of cerebral aneurysms over a mid-to-long-term follow-up.

    Rodríguez-Fernández, Claudio / Ruiz-Garcia, Pedro / Garcia-Sanchez, Maria Jesús / Manrique-Zegarra, Martiel / Toledano-Illán, Carlos / Escartin, Jorge / Vences, Miguel Angel / Rubio, Luis Angel / Luttich, Alex / Pumar, José Manuel

    Frontiers in neurology

    2024  Volume 15, Page(s) 1369443

    Abstract: Background: Long-term follow-up of cerebral aneurysms treated with the Silk Vista Baby (SVB) flow diverter is lacking. This study aimed to assess the technical success, procedural safety, and efficacy of the SVB (Balt, Montmorency, France) for the ... ...

    Abstract Background: Long-term follow-up of cerebral aneurysms treated with the Silk Vista Baby (SVB) flow diverter is lacking. This study aimed to assess the technical success, procedural safety, and efficacy of the SVB (Balt, Montmorency, France) for the treatment of intracranial aneurysms in small cerebral vessels over a mid-to long-term follow-up.
    Methods: We retrospectively analyzed a prospectively maintained database of patients treated with the SVB between September 2018 and June 2021. Data regarding patient demographics, aneurysm characteristics, and technical procedures were also collected. Angiographic and clinical findings were recorded during the procedure and over a period of at least 12 months.
    Results: Angiographic and clinical follow-up data were available for 50 patients/50 aneurysms. The procedural complication rate was 8%. At 12 months, the final results showed a technical success rate of 100%, the re rupture rate was 0%, neuromorbidity and mortality rates of 4 and 0%, respectively, and an almost complete occlusion rate of 94%.
    Conclusion: Treatment of complex intracranial aneurysms with the SVB was safe and effective. Long-term results showed high rates of adequate and stable occlusions.
    Language English
    Publishing date 2024-03-27
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2024.1369443
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Safety and efficacy of intracranial aneurysm embolization using the "combined remodeling technique": low-profile stents delivered through double lumen balloons: a multicenter experience.

    Martínez-Galdámez, Mario / Orlov, Kirill / Kadziolka, Krzysztof / Puthuran, Mani / Kalousek, Vladimir / Pabón, Boris / Escartín, Jorge / Rodríguez, Claudio / Chandran, Arun / Kislitsin, Dmitry / Berestov, Vadim / Vega, Pedro / Diaz, Carlos / Dabus, Guilherme

    Neuroradiology

    2019  Volume 61, Issue 9, Page(s) 1067–1072

    Abstract: Purpose: Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both ... ...

    Abstract Purpose: Since appearance of the balloon-remodeling technique and stent-assisted coiling, complex aneurysms have been treated successfully by endovascular means worldwide. Although these two techniques have been widely proven, the combination of both traditionally made the procedures more complicated technically. The aim of our study was to determine the technical success, safety, and efficacy of the low-profile stents delivered through double lumen balloons.
    Methods: Clinical, procedural, and angiographic data were analyzed.
    Results: Eighty-four patients (55 women; age range 20-81 years) harboring 86 aneurysms were included in this study. Aneurysm maximal diameter ranged from 2 to 26 mm, with mean 7.5 mm. There were 62 unruptured, 15 recanalized, and 9 acutely ruptured aneurysms. Aneurysm locations were ACoA (31), MCA (36), supraclinoid ICA (4), carotid bifurcation (2), basilar (7), PCA (3), PICA (2), and VA (1). Ninety-three devices were implanted (63 LVIS jr, 15 LEO Baby, 14 ACCLINO Flex and 1 Neuroform Atlas) through the double lumen balloons (Scepter C or XC and Eclipse 2 L). We found 2 minor clinical events (2.4%) and 1 major event (1.2%). Total intra-procedural technical complication rate was 11.6%. Follow-up was available for 71 patients with an average follow-up of 7 months. Complete and near complete occlusion was 90.1%. Residual aneurysms were seen in 9.9%.
    Conclusion: The "combined remodeling technique" with low-profile stents delivered through double-lumen balloons is technically feasible, safe, and effective for the treatment of intracranial aneurysms. This technique allows the operator to avoid extra maneuvers.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Cerebral Angiography ; Embolization, Therapeutic/instrumentation ; Embolization, Therapeutic/methods ; Endovascular Procedures/instrumentation ; Endovascular Procedures/methods ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/therapy ; Male ; Middle Aged ; Retrospective Studies ; Stents ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2019-06-15
    Publishing country Germany
    Document type Journal Article ; Multicenter Study
    ZDB-ID 123305-1
    ISSN 1432-1920 ; 0028-3940
    ISSN (online) 1432-1920
    ISSN 0028-3940
    DOI 10.1007/s00234-019-02240-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Optical coherence tomography: Translation from 3D-printed vascular models of the anterior cerebral circulation to the first human images of implanted surface modified flow diverters.

    Martínez-Galdámez, Mario / Escartín, Jorge / Pabón, Boris / Diaz, Carlos / Martín-Reyes, Roberto / Hermosín, Antonio / Crespo, Eduardo / Rodríguez, Claudio / Monedero, Gonzalo / Joshi, Krishna / Lopes, Demetrius K

    Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

    2018  Volume 25, Issue 2, Page(s) 150–156

    Abstract: Background: The new generation of flow diverters includes a surface modification with a synthetic biocompatible polymer, which makes the device more biocompatible and less thrombogenic. Optical coherence tomography (OCT) can be used to visualize ... ...

    Abstract Background: The new generation of flow diverters includes a surface modification with a synthetic biocompatible polymer, which makes the device more biocompatible and less thrombogenic. Optical coherence tomography (OCT) can be used to visualize perforators, stent wall apposition, and intra-stent thrombus. Unfortunately real world application of this technology has been limited because of the limited navigability of these devices in the intracranial vessels. In this report, we share our experience of using 3D-printed neurovascular anatomy models to simulate and test the navigability of a commercially available OCT system and to show the application of this device in a patient treated with the new generation of surface modified flow diverters.
    Material and methods: Navigability of OCT catheters was tested in vitro using four different 3D-printed silicone replicas of the intracranial anterior circulation, after the implantation of surface modified devices. Intermediate catheters were used in different tortuous anatomies and positions. After this assessment, we describe the OCT image analysis of a Pipeline Shield for treating an unruptured posterior communicating artery (PCOM) aneurysm.
    Results: Use of intermediate catheters in the 3D-printed replicas was associated with better navigation of the OCT catheters in favorable anatomies but did not help as much in unfavorable anatomies. OCT image analysis of a PCOM aneurysm treated with Pipeline Embolization Device Shield demonstrated areas of unsatisfactory apposition with no thrombus formation.
    Conclusions: OCT improves the understanding of the flow diversion technology. The development of less thrombogenic devices, like the Pipeline Flex with Shield Technology, reinforces the need for intraluminal imaging for neurovascular application.
    MeSH term(s) Angiography, Digital Subtraction ; Biocompatible Materials ; Cerebrovascular Circulation ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Models, Anatomic ; Platelet Aggregation Inhibitors/administration & dosage ; Printing, Three-Dimensional ; Prosthesis Design ; Stents ; Tomography, Optical Coherence
    Chemical Substances Biocompatible Materials ; Platelet Aggregation Inhibitors
    Language English
    Publishing date 2018-11-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 1354913-3
    ISSN 2385-2011 ; 1591-0199 ; 1123-9344
    ISSN (online) 2385-2011
    ISSN 1591-0199 ; 1123-9344
    DOI 10.1177/1591019918808466
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Modified Wong's classification improves the accuracy of rectal cancer staging by endorectal ultrasound and MRI.

    Muñoz, Elena / Granero-Castro, Pablo / Frasson, Matteo / Escartin, Jorge / Esclapez, Pedro / Campos, Salvador / Flor-Lorente, Blas / Garcia-Granero, Eduardo

    Diseases of the colon and rectum

    2013  Volume 56, Issue 12, Page(s) 1332–1338

    Abstract: Background: Douglas Wong proposed a new classification of tumor penetration in the rectal wall (T stage) in an attempt to incorporate the prognostic heterogeneity of T3 rectal cancers into the preoperative staging.: Objective: This study aimed to ... ...

    Abstract Background: Douglas Wong proposed a new classification of tumor penetration in the rectal wall (T stage) in an attempt to incorporate the prognostic heterogeneity of T3 rectal cancers into the preoperative staging.
    Objective: This study aimed to evaluate if the accuracy of endorectal ultrasound and MRI in predicting rectal cancer T staging improves when using a modified Wong's classification.
    Design: This prospective series compares local standard TN staging and a modified Wong's classification.
    Settings: This study was conducted by a specialized Colorectal Multidisciplinary Team at a tertiary teaching hospital.
    Patients: Seventy patients underwent surgery for middle or low rectal cancer between 2002 and 2008 without neoadjuvant radiochemotherapy. We compared the preoperative staging with the pathological staging to determine the preoperative accuracy of endorectal ultrasound and MRI when using a modified Wong's classification vs the standard TN classification.
    Interventions: A modified version of Wong's classification was used for preoperative and pathological staging.
    Main outcome measures: The primary outcome measured was the accuracy in the preoperative T staging.
    Results: The overall accuracy of endorectal ultrasound and MRI in assessing T staging was 68.6% and 72.9% (uT1/2, 90%; uT3, 58.3%; and uT4, 100% and rT1/2, 88%; rT3, 63.4%; and rT4, 75%). By using the proposed modified Wong's classification, the overall accuracy of endorectal ultrasound and MRI improved to 82.9% and 90%.
    Limitations: The interobserver variability in radiological assessment was not evaluated.
    Conclusion: With use of the modified Wong's classification proposed in this study, the overall accuracy of preoperative imaging in assessing T staging of rectal cancer is substantially improved, especially when endorectal ultrasound and MRI stage match, enhancing the selection of patients for neoadjuvant radiochemotherapy.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Carcinoma/diagnostic imaging ; Carcinoma/pathology ; Carcinoma/therapy ; Endosonography ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Rectal Neoplasms/diagnostic imaging ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy
    Keywords covid19
    Language English
    Publishing date 2013-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 212581-x
    ISSN 1530-0358 ; 0012-3706
    ISSN (online) 1530-0358
    ISSN 0012-3706
    DOI 10.1097/DCR.0b013e3182a69a3b
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience.

    Martínez-Galdámez, Mario / Biondi, Alessandra / Kalousek, Vladimir / Pereira, Vitor M / Ianucci, Giuseppe / Gentric, Jean-Christophe / Mosimann, Pascal J / Brisbois, Denis / Schob, Stefan / Quäschling, Ulf / Kaesmacher, Johannes / Ognard, Julien / Escartín, Jorge / Tsang, Chun On Anderson / Čulo, Branimir / Chabert, Emmanuel / Turjman, Francis / Barbier, Charlotte / Mihalea, Cristian /
    Spelle, Laurent / Chapot, René

    Journal of neurointerventional surgery

    2019  Volume 11, Issue 7, Page(s) 723–727

    Abstract: Purpose: The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.: Material/methods: Clinical, ... ...

    Abstract Purpose: The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.
    Material/methods: Clinical, procedural, and angiographic data were analyzed.
    Results: 41 consecutive patients (28 women; age average 50.5 years) with 43 aneurysms were treated with SVB. Aneurysm sizes were classified by their maximum diameter, with an average size of 9.5 mm (range 2-30 mm). Thirty-four cases were unruptured. five aneurysms previously ruptured, had recurrence after the initial coiling. There were two ruptured cases. Aneurysms' locations were: M1 segment (five cases), M2 segment (three cases), M3 segment (one case), middle cerebral artery (MCA) bifurcation (six cases), carotid-T (two cases), anterior communicating artery/A1/A2 (11 cases), pericallosal artery (four cases), supraclinoid ICA (two cases), PCom (one case), V4 segment (three cases), PCA (three cases), SCA (one case), and PICA (one case). We had five intraprocedural complications which resolved without clinical consequences and three events postprocedural events. Initial occlusion rates were: eight aneurysms (18.6%) were completely occluded, five aneurysms (11.6%) showed near-complete occlusion, four cases (9.3%) showed incomplete filling, and 26 cases (60.4%) showed persisting filling. The mRS score at discharge from the hospital did not change from the admission mRS score.
    Conclusion: Our study demonstrated that the use of the new low-profile flow diverter, SVB device, for the treatment of intracranial aneurysms is feasible and technically safe.
    MeSH term(s) Adult ; Aged ; Angiography/methods ; Angiography/trends ; Anterior Cerebral Artery/diagnostic imaging ; Anterior Cerebral Artery/surgery ; Embolization, Therapeutic/methods ; Endovascular Procedures/methods ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Middle Cerebral Artery/diagnostic imaging ; Middle Cerebral Artery/surgery ; Perioperative Care/methods ; Perioperative Care/trends ; Retrospective Studies ; Self Expandable Metallic Stents/adverse effects ; Self Expandable Metallic Stents/trends ; Treatment Outcome
    Language English
    Publishing date 2019-03-09
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 2514982-9
    ISSN 1759-8486 ; 1759-8478
    ISSN (online) 1759-8486
    ISSN 1759-8478
    DOI 10.1136/neurintsurg-2019-014770
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Evaluation of Institut Georges Lopez-1 preservation solution in pig pancreas transplantation: a pilot study.

    García-Gil, Francisco A / Fuentes-Broto, Lorena / Albendea, Carlos D / Serrano, María Trinidad / Roselló-Catafau, Joan / Lampreave, Fermín / López-Pingarrón, Laura / Escartín, Jorge / Soria, Joaquín / Garcia, Joaquín J / Fernández-Cruz, Laureano

    Transplantation

    2014  Volume 97, Issue 9, Page(s) 901–907

    Abstract: Background: Institut Georges Lopez-1 preservation solution (IGL-1) is an emerging extracellular-type electrolyte solution, low in viscosity, containing polyethylene glycol 35 as a colloid. Although IGL-1 has shown beneficial outcomes in kidney and liver ...

    Abstract Background: Institut Georges Lopez-1 preservation solution (IGL-1) is an emerging extracellular-type electrolyte solution, low in viscosity, containing polyethylene glycol 35 as a colloid. Although IGL-1 has shown beneficial outcomes in kidney and liver preservation, this pilot study is the first to evaluate the efficacy of IGL-1 in pancreas transplantation (PT) compared with the University of Wisconsin solution (UW).
    Methods: Sixteen Landrace pigs underwent allogeneic PT with 16 hr of cold ischemia. Grafts were preserved with IGL-1 (n=8) or UW (n=8). No immunosuppression was administered. We analyzed graft function, the acute-phase response, and oxidative stress in the pancreatic graft monitoring membrane fluidity and lipid peroxidation.
    Results: All eight grafts with IGL-1, but only six with UW, were functioning. Graft failures with UW resulted from graft thrombosis. There were no differences between the two solutions in the number of normoglycemic days (IGL-1: 11.5 ± 6.2 versus UW: 8.5 ± 4.4 days, P=0.1357), nor in lipid peroxidation during 16-hr cold ischemia (P=0.672), or reperfusion (P=0.185), but IGL-1 prevented changes in membrane fluidity after reperfusion when compared with UW (P=0.026).
    Conclusion: IGL-1 offered the same degree of safety and effectiveness as UW in our model of pig PT with 16 hr of cold ischemia.
    MeSH term(s) Adenosine/chemistry ; Allopurinol/chemistry ; Animals ; Colloids/chemistry ; Electrolytes ; Female ; Glutathione/chemistry ; Immunosuppression ; Insulin/chemistry ; Ischemia ; Kidney/pathology ; Lipid Peroxidation ; Liver/pathology ; Organ Preservation/methods ; Organ Preservation Solutions/chemistry ; Oxidative Stress ; Pancreas/pathology ; Pancreas Transplantation/methods ; Pilot Projects ; Polyethylene Glycols/chemistry ; Raffinose/chemistry ; Swine ; Time Factors ; Viscosity
    Chemical Substances Colloids ; Electrolytes ; IGL-1 solution ; Insulin ; Organ Preservation Solutions ; University of Wisconsin-lactobionate solution ; Polyethylene Glycols (30IQX730WE) ; Allopurinol (63CZ7GJN5I) ; Glutathione (GAN16C9B8O) ; Adenosine (K72T3FS567) ; Raffinose (N5O3QU595M)
    Language English
    Publishing date 2014-05-15
    Publishing country United States
    Document type Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 208424-7
    ISSN 1534-6080 ; 0041-1337
    ISSN (online) 1534-6080
    ISSN 0041-1337
    DOI 10.1097/TP.0000000000000050
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  8. Article ; Online: Melatonin prolongs graft survival of pancreas allotransplants in pigs.

    García-Gil, Francisco A / Albendea, Carlos D / Escartín, Jorge / Lampreave, Fermin / Fuentes-Broto, Lorena / Roselló-Catafau, Joan / López-Pingarrón, Laura / Reiter, Russel J / Alvarez-Alegret, Ramiro / García, Joaquín J

    Journal of pineal research

    2011  Volume 51, Issue 4, Page(s) 445–453

    Abstract: Oxidative stress is involved in ischemia-reperfusion injury and allograft rejection after transplantation. We studied two well-known antioxidants, melatonin and ascorbic acid (AA), in relation to the survival of a pancreas transplantation model without ... ...

    Abstract Oxidative stress is involved in ischemia-reperfusion injury and allograft rejection after transplantation. We studied two well-known antioxidants, melatonin and ascorbic acid (AA), in relation to the survival of a pancreas transplantation model without immunosuppression. Forty-eight Landrace pigs were divided into three groups (n = 16 each; eight donors and eight recipients) that received melatonin, AA, or no antioxidant therapy (controls). Melatonin and AA were administered (10 mg/kg body weight) intravenously to donors and recipients during surgery and on postoperative days 1-7. The molecules were also added (5 mm) to a University of Wisconsin preservation solution during organ cold storage. Melatonin significantly delayed acute rejection and prolonged allograft survival (25.1 ± 7.7 days) compared with the controls (8.1 ± 0.8 days, P = 0.013) and the AA group (9.4 ± 1.6 days, P = 0.049). Melatonin reduced indicators of oxidative stress, malondialdehyde, and 4-hydroxyalkenals, in pancreatic samples collected during procurement, cold ischemia, and reperfusion. Melatonin also reduced serum pig-major acute-phase protein/inter-α-trypsin inhibitor heavy chain 4 (pMAP/ITIH(4)) in the early post-transplantation period. AA only partially reduced oxidative damage 30 min postreperfusion and failed to prevent pMAP/ITIH(4) elevations. These findings suggested that melatonin may be a useful therapeutic tool for organ transplantation.
    MeSH term(s) Alpha-Globulins/metabolism ; Animals ; Antioxidants/therapeutic use ; Ascorbic Acid/therapeutic use ; Female ; Graft Survival/drug effects ; Melatonin/therapeutic use ; Oxidative Stress/drug effects ; Pancreas Transplantation/methods ; Swine ; Transplantation, Homologous
    Chemical Substances Alpha-Globulins ; Antioxidants ; inter-alpha-inhibitor (39346-44-6) ; Melatonin (JL5DK93RCL) ; Ascorbic Acid (PQ6CK8PD0R)
    Language English
    Publishing date 2011-11
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632697-3
    ISSN 1600-079X ; 0742-3098
    ISSN (online) 1600-079X
    ISSN 0742-3098
    DOI 10.1111/j.1600-079X.2011.00908.x
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  9. Article: Laparoscopic biliopancreatic diversion with distal gastric preservation: technique and three-year followup.

    Resa, J Joaquín / Solano, Jorge / Fatás, J Antonio / Blas, J Luis / Monzón, Andrés / García, Alejandro / Lagos, Javier / Escartin, Jorge

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2004  Volume 14, Issue 3, Page(s) 131–134

    Abstract: Background: Biliopancreatic diversion (BPD) has been used satisfactorily as one of several surgical treatments against morbid obesity in order to achieve long-term weight reduction. Our goal was to develop the BPD laparoscopically in humans in order to ... ...

    Abstract Background: Biliopancreatic diversion (BPD) has been used satisfactorily as one of several surgical treatments against morbid obesity in order to achieve long-term weight reduction. Our goal was to develop the BPD laparoscopically in humans in order to improve postoperative recovery and to reduce early and late complications, above all those derived from the abdominal wall, while maintaining the weight reduction results achieved. In addition, in order to reduce the laparoscopic difficulty of BPD technique and some complications associated with gastrectomy, we only carried it out in cases in which we considered it indispensable.
    Patients and methods: Since October 2000 we have performed 50 laparoscopic BPD with distal gastric preservation (39 women and 11 men). We preserve the distal stomach if the upper digestive endoscopy with biopsy does not show pathological findings.
    Results: Two operations (within the first ten cases) were converted to open surgery. The average operating time was 177.7 minutes (range, 110-360 minutes). There were no immediate postoperative complications. There was no postoperative mortality.
    Conclusion: It has been proven that BPD can be performed satisfactorily using laparoscopy, but this technique requires a very skilled and experienced laparoscopic surgeon. Avoiding gastrectomy is a very interesting option in order to reduce technical difficulties, surgeon stress, duration of the operation, patient stress, and, probably, postoperative morbidity and mortality. Laparoscopic BPD with distal gastric preservation is a very promising bariatric procedure with potential advantages over laparoscopic BPD with gastrectomy or open BPD.
    MeSH term(s) Adult ; Biliopancreatic Diversion/methods ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Laparoscopy/methods ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Weight Loss
    Language English
    Publishing date 2004-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1381909-4
    ISSN 1092-6429
    ISSN 1092-6429
    DOI 10.1089/1092642041255469
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  10. Article: Laparoscopic biliopancreatic diversion: technical aspects and results of our protocol.

    Resa, J Joaquín / Solano, Jorge / Fatás, J Antonio / Blas, J Luis / Monzón, Andrés / García, Alejandro / Lagos, Javier / Escartin, Jorge

    Obesity surgery

    2004  Volume 14, Issue 3, Page(s) 329–33; discussion 333

    Abstract: Background: Biliopancreatic diversion (BPD) has been an excellent operation for morbid obesity to achieve long-term weight reduction. We present our laparoscopic BPD protocol, which includes laparoscopic BPD with or without gastrectomy.: Methods: Our ...

    Abstract Background: Biliopancreatic diversion (BPD) has been an excellent operation for morbid obesity to achieve long-term weight reduction. We present our laparoscopic BPD protocol, which includes laparoscopic BPD with or without gastrectomy.
    Methods: Our two interventions are: 1) BPD (Scopinaro) by laparoscopy in patients with findings on gastroscopy; 2) BPD by laparoscopy with proximal gastric division without resection in patients without findings on gastroscopy. Since October 2000, we performed 65 laparoscopic BPDs (45 women, 20 men).
    Results: 4 cases were converted to open surgery, 3 in the first 10 cases. The average operating-time was 176 minutes (360-110). We detected 2 stenoses of the gastric anastomosis. 2 patients had to be re-operated during the immediate postoperative period because of a leak from the jejuno-ileal anastomosis and a hemoperitoneum.
    Conclusion: BPD can be performed satisfactorily by laparoscopy. Avoiding the gastrectomy is an interesting option to reduce technical difficulties, the surgeon's stress, duration of the operation, the patient's stress, and, probably, postoperative morbidity and mortality. We consider an upper digestive endoscopy to be mandatory to determine, before operating, if the patient will need a gastrectomy, depending on its results.
    MeSH term(s) Biliopancreatic Diversion/methods ; Clinical Protocols ; Female ; Gastrectomy ; Humans ; Laparoscopy ; Male ; Middle Aged ; Obesity, Morbid/surgery ; Treatment Outcome
    Language English
    Publishing date 2004-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1381/096089204322917837
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